Article
Clinical Neurology
Joshua S. Catapano, Caleb Rutledge, Kavelin Rumalla, Kunal P. Raygor, Visish M. Srinivasan, Stefan W. Koester, Anna R. Kimata, Kevin L. Ma, Mohamed A. Labib, Robert F. Spetzler, Michael T. Lawton
Summary: This study validates the accuracy of the Brainstem Cavernous Malformation (BSCM) grading system in predicting neurological outcomes in a large cohort of patients from two high-volume surgeons. The BSCM grading system establishes categories of low-, intermediate-, and high-grade BSCMs and provides guidance for surgical decision-making.
JOURNAL OF NEUROSURGERY
(2022)
Article
Clinical Neurology
Joshua S. Catapano, Dimitri Benner, Emmajane G. Rhodenhiser, Kavelin Rumalla, Christopher S. Graffeo, Visish M. Srinivasan, Ethan A. Winkler, Michael T. Lawton
Summary: Safe entry zones (SEZs) provide a safe approach for the treatment of deep brainstem cavernous malformations (BSCMs). Preoperative MRI can accurately predict the proximity of deep BSCMs, but may overestimate the lesion's proximity for superficial BSCMs. Patients achieved favorable neurological outcomes with the use of SEZs, demonstrating their safety and efficacy.
JOURNAL OF NEUROSURGERY
(2023)
Article
Clinical Neurology
Philipp Dammann, Annika Herten, Alejandro N. Santos, Laurel Rauschenbach, Bixia Chen, Marvin Darkwah Oppong, Boerge Schmidt, Michael Forsting, Christoph Kleinschnitz, Ulrich Sure
Summary: This study assessed outcomes after surgery for brainstem cavernous malformations (BSCMs) and found that patients' health-related quality of life (HRQOL) was impaired post-surgery, especially in those with unfavorable functional outcomes. Psychological impairment was more significant in unfavorable outcome patients, while minimal in those with favorable outcomes. Symptoms related to brainstem and cranial nerves had a notable impact on HRQOL.
JOURNAL OF NEUROSURGERY
(2021)
Article
Clinical Neurology
Laurel Rauschenbach, Alejandro N. Santos, Thiemo F. Dinger, Annika Herten, Marvi Darkwah Oppong, Borge Schmidt, Mehdi Chihi, Johannes Haubold, Ramazan Jabbarli, Karsten H. Wrede, Ulrich Sure, Philipp Dammann
Summary: This study evaluated the predictive value of intraoperative neuromonitoring in brainstem cavernous malformation surgery, finding that MEP and SSEP decreases were associated with early motor or sensory deficits. ROC analyses showed good performance of MEPs and SSEPs in predicting early deficits. However, subdural air accumulation during surgery may impair the reliability of IONM.
WORLD NEUROSURGERY
(2021)
Article
Clinical Neurology
Giacomo Bertolini, Francesco Maria Calamo Specchia, Patrizia Bertolini, Ermanno Giombelli
Summary: The resection of hemorrhagic brainstem cavernomas is feasible and safe, even in select infant patients. The timing and microsurgical technique play a crucial role in preventing postoperative deficits.
ACTA NEUROCHIRURGICA
(2023)
Editorial Material
Clinical Neurology
Sebastian Anibal Alejandro, Juan Leonardo Serrato-Avila, Samantha Lorena Paganelli, Jose Ernesto Chang Mulato, Evelyn Judith Vela Rojas, Ana Paula Viera Neves, Daniela de Souza Coelho, Marcos Devanir Silva da Costa, Hugo Leonardo Doria-Netto, Jose Maria Campos Filho, Feres Chaddad-Neto
Summary: Cavernous malformations are rare, with clinical presentations depending on the location of the lesion. Patients may experience acute or chronic visual disturbances and other symptoms. Surgical intervention can be an effective treatment option.
WORLD NEUROSURGERY
(2022)
Article
Clinical Neurology
Alejandro N. Santos, Laurel Rauschenbach, Marvin Darkwah Oppong, Bixia Chen, Annika Herten, Michael Forsting, Ulrich Sure, Philipp Dammann
Summary: Treatment indications for patients with brainstem cavernous malformations (BSCMs) are difficult and controversial. Authors aimed to validate the performance of two proposed BSCM grading systems. The study found that multiple bleedings, lesion diameter, and patient age were predictors of unfavorable postoperative outcomes, and that both the LG and the DS scores were robust tools for estimating patient outcome.
JOURNAL OF NEUROSURGERY
(2021)
Article
Clinical Neurology
Zixiao Yang, Xiang Zou, Jianping Song, Wei Zhu, Ying Mao
Summary: This study introduced a supplementary technical trick for localizing hidden tiny lesions inside the brainstem when a developmental venous anomaly (DVA) is present on the brainstem surface. This method successfully treated 11 patients with deep-seated BSCMs, without worsening postoperative brainstem edema, and resulted in improved quality of life for the patients.
WORLD NEUROSURGERY
(2021)
Review
Clinical Neurology
Ibrahem Albalkhi, Areez Shafqat, Othman Bin-Alamer, Arka N. Mallela, Chloe Kuminkoski, Mohamed A. Labib, Michael J. Lang, Michael T. Lawton, Jacques J. Morcos, William T. Couldwell, Hussam Abou-Al-Shaar
Summary: Microsurgical resection of brainstem cavernous malformations can lead to favorable long-term functional outcomes with transient complications in the majority of patients. The proportions of improved, stable, and worsened functional outcomes after the surgery were 56.7%, 28.6%, and 12.6% respectively. Complete resection of the CM was achieved in 93.3% of the cases.
NEUROSURGICAL REVIEW
(2023)
Article
Clinical Neurology
Annika Herten, Dino Saban, Alejandro N. Santos, Bixia Chen, Marvin Darkwah Oppong, Laurel Rauschenbach, Ramazan Jabbarli, Karsten Wrede, Ulrike Bingel, Daniel Mueller, Dagny Holle-Lee, Boerge Schmidt, Yan Li, Ulrich Sure, Philipp Dammann
Summary: This study assessed the occurrence and significance of postoperative neuropathic pain in patients with surgically treated brainstem cavernous malformations. It was found that 8% of patients suffered from NP after surgery, impacting their health-related quality of life and life satisfaction.
EUROPEAN JOURNAL OF NEUROLOGY
(2022)
Article
Clinical Neurology
Joachim Oertel, Gerrit Fischer, Stefan Linsler, Matthias Huelser, Christoph Sippl, Fritz Teping
Summary: This study provides detailed information on the role of endoscopy in surgical resection of brainstem cavernous malformations. By retrospectively analyzing medical documentation, radiologic studies, and intraoperative video documentation, the study found that endoscopic techniques can be safely implemented and enable a smaller surgical corridor for brainstem cavernous malformations.
NEUROSURGICAL REVIEW
(2022)
Article
Clinical Neurology
Caiquan Huang, Helmut Bertalanffy, Souvik Kar, Yoshihito Tsuji
Summary: The study found that a deep intrinsic MCM location does not necessarily lead to unfavorable clinical outcomes after microsurgical lesionectomy in a large patient population. Predicting the aspect of the midbrain surface based solely on preoperative MR images was not reliable enough.
ACTA NEUROCHIRURGICA
(2021)
Article
Clinical Neurology
Nathan Beucler, Sebastien Boissonneau, Aurelia Ruf, Stephane Fuentes, Romain Carron, Henry Dufour
Summary: This study reviewed the proportion of CBS caused by bleeding episode arising from brainstem cavernous malformation reported in the literature. Hemorrhagic BCM accounted for approximately 7% of CBS cases. Microsurgical excision may be indicated after the second bleeding episode.
Article
Clinical Neurology
Joshua S. Catapano, Kavelin Rumalla, Visish M. Srinivasan, Peter M. Lawrence, Kristen Larson Keil, Michael T. Lawton
Summary: This study proposes a novel taxonomy for midbrain cavernous malformations based on clinical presentation and anatomical location. Different subtypes of midbrain BSCMs were identified and associated with distinct neurological symptoms and surgical approaches. The proposed taxonomy can enhance diagnostic acumen, improve surgical planning, and optimize patient outcomes.
JOURNAL OF NEUROSURGERY
(2022)
Article
Clinical Neurology
Tomokatsu Hori, Mikhail Chernov, Yasir A. Alshebib, Yuichi Kubota, Seigo Matsuo, Hideki Shiramizu, Yoshikazu Okada
Summary: This study evaluated the long-term outcomes after resection of brainstem cavernous malformations (BSCMs) and assessed the usefulness of the Lawton grading system. The results showed that experienced neurosurgeons can safely and effectively remove hemorrhagic BSCMs, although there may be postoperative neurological morbidity.
JOURNAL OF NEUROSURGERY
(2023)
Review
Cell Biology
Renata Parissi Buainain, Matheus Negri Boschiero, Bruno Camporeze, Paulo Henrique Pires de Aguiar, Fernando Augusto Lima Marson, Manoela Marques Ortega
Summary: The study reviewed the relationship between SNVs within miRNA sequences or their target genes and epilepsy susceptibility. It found that SNVs rs2910164 and rs57095329 may modify the expression level of miR-146a and the risk for epilepsy, while other SNVs could interfere in inflammatory pathway genes. The main limitation of the studies is the small sample size.
CELLULAR AND MOLECULAR NEUROBIOLOGY
(2022)
Review
Clinical Neurology
Giovanna Zambo Galafassi, Pedro Henrique Simm Pires de Aguiar, Renata Faria Simm, Paulo Roberto Franceschini, Marco Prist Filho, Jorge Roberto Pagura, Paulo Henrique Pires de Aguiar
Summary: The review of evidence on deep brain stimulation (DBS), motor cortex stimulation (MCS), spinal cord stimulation (SCS), and posterior insula stimulation (PIS) for neuropathic pain (NP) shows varying levels of effectiveness in managing NP, with MCS, DBS, and SCS having consistent evidence as possible treatments. However, definitive conclusions on the most suitable procedure for each cause of NP remain elusive, highlighting the need for further research in this field.
WORLD NEUROSURGERY
(2021)
Article
Neurosciences
Rogerio Aires, Giovanna Galafassi, Maria Carla Vieira Pinho, Daniel de Araujo Paz, Thiago Salati, Cassiano Marchi, Paulo Henrique Pires de Aguiar
Summary: This study aimed to develop a prognostic scale for ruptured intracranial aneurysms in the elderly, and found smoking and arterial hypertension to be comorbidities associated with poor prognosis, while Hunt-Hess grading, Rankin grading, and Glasgow Coma Scale were clinical variables associated with poor prognosis. This study can help individualize treatment and predict clinical outcomes.
INTERNATIONAL JOURNAL OF NEUROSCIENCE
(2023)
Article
Surgery
Desiree Elizabeth Pasqualetto Antikievicz, Giulio Bartie Rossi, Marcos Vinicius Calfatt Maldaun, Daniel Gripp, Cassiano de Marchi, Luiz Vinicius de Alcantara Sousa, Paulo Henrique Pires de Aguiar
Summary: This study analyzed the effects of myelomalacia and ossification of the posterior longitudinal ligament as prognostic factors in patients with cervical canal compression undergoing laminoplasty. Patients without ligament ossification and myelomalacia showed better postoperative improvement compared to those with these conditions. Further studies with larger samples are needed to confirm these prognostic factors in patients with cervical spondylotic myelopathy undergoing laminoplasty.
BRAZILIAN NEUROSURGERY-ARQUIVOS BRASILEIROS DE NEUROCIRURGIA
(2022)
Review
Surgery
Fernando Furtado Santos, Andre Akira Ramos Takahashi, Andre Ponce, Paulo Roberto Franceschini, Paulo Henrique Pires de Aguiar
Summary: CRPS is a disease that causes intense pain in the upper and lower limbs, significantly impairing the quality of life. Its pathophysiology is not fully understood and requires further research. Treatments for CRPS vary in effectiveness.
BRAZILIAN NEUROSURGERY-ARQUIVOS BRASILEIROS DE NEUROCIRURGIA
(2022)
Review
Surgery
Adriano de Medeiros Barbosa Rodrigues, Henrique Nicola Santo Antonio Bernardo, Maria Clara Cardoso Seba, Carlos Alberto de Almeida Castro Junior, Paulo Roberto Franceschini, Paulo Henrique Pires de Aguiar
Summary: Surgical resection of the insula is effective in reducing seizures and is considered beneficial and safe for patients. It requires difficult surgical access and a wide anatomical knowledge, as well as preoperative planning. There are two types of surgical approaches: transsylvian and transcortical. Temporary complications may occur, but the outcomes are highly satisfactory in terms of seizure control.
BRAZILIAN NEUROSURGERY-ARQUIVOS BRASILEIROS DE NEUROCIRURGIA
(2022)
Article
Clinical Neurology
Matheus Bernardon Morillos, Paulo Henrique Pires de Aguiar, Paulo Roberto Franceschini, Juliana Avila Duarte, Cristian Daniel Piccini, Alessandro Finkelsztejn
Summary: Report of a case in which a patient with multiple sclerosis developed primary central nervous system lymphoma after treatment with fingolimod. Although causal relationship cannot be established, there are reported cases in literature of lymphoma appearing after the use of this medication. Epidemiological studies are needed to establish a relationship between its occurrence and the use of immunosuppressants.
NEUROLOGICAL SCIENCES
(2023)
Review
Medicine, Research & Experimental
Davi Ferreira Soares, Paulo Henrique Pires de Aguiar
Summary: This study aimed to compare the effectiveness of corpus callosotomy (CC) and vagus nerve stimulation (VNS) in the treatment of Lennox-Gastaut syndrome (LGS) patients. Through a systematic review and meta-analysis, it was found that both CC and VNS treatments were significantly beneficial in reducing seizures in LGS patients, with no statistical difference between the two methods.
Article
Neurosciences
Mariana Ribeiro Costa, Amanda Yasmin Ilario dos Santos, Tais Browne de Miranda, Rogerio Aires, Alex de Camargo Coque, Elizabeth Cristina Perez Hurtado, Maria Martha Bernardi, Vanessa Gallego Arias Pecorari, Denise Carleto Andia, Alexander Birbrair, Gilles J. Guillemin, Alexandra Latini, Rodrigo A. da Silva
Summary: Sonic Hedgehog (Shh) signaling plays a critical role in CNS development and its dysregulation leads to neurological disorders. However, the regulation of Shh signaling in the adult brain is not well understood. This study investigated the effects of DNA methylation on the transcriptional control of Shh signaling pathway members as well as its modulation by inflammation. The findings demonstrate the importance of methylation in the promoter regions of Shh pathway members in determining transcriptional patterns in the adult brain, and reveal the impact of neuroinflammation on the transcriptional control of these genes.
Article
Surgery
Benedito Jamilson Araujo Pereira, Sueli M. Oba-Shinjo, Paulo Henrique Pires de Aguiar, Antonio Nogueira de Almeida, Wellingson da Silva Paiva, Suely Kazue Nagahashi Marie
Summary: This study analyzed the expression of AQP4 in meningiomas using immunohistochemistry and qPCR, and found that AQP4 expression was not associated with the malignant progression of meningiomas.
BRAZILIAN NEUROSURGERY-ARQUIVOS BRASILEIROS DE NEUROCIRURGIA
(2023)
Article
Medicine, General & Internal
Fernanda Junqueira Cesar Pirola, Bruno Antonio Muzel Santos, Gabriela Feres Sapienza, Lucas Yuri Cetrangolo, Caio Henrique Wthen Gambacorta Geranutti, Paulo Henrique Pires de Aguiar
Summary: This case report describes a patient who developed symptoms consistent with Miller-Fisher Syndrome after receiving the COVID-19 vaccine, with improvement seen after treatment.
JOURNAL OF MEDICAL CASE REPORTS
(2022)
Review
Clinical Neurology
Rafaela Farias Vidigal Nascimento, Leonardo Zumerkorn Pipek, Paulo Henrique Pires de Aguiar
Summary: This study compared the pain outcomes and complications of PBC and MVD procedures for patients with trigeminal neuralgia through a systematic review and meta-analysis. The results showed that MVD had better pain relief than PBC and is the best surgical option for treating trigeminal neuralgia.
JOURNAL OF CLINICAL NEUROSCIENCE
(2023)
Article
Clinical Neurology
Rafael Trindade Tatit, Caroline Pacheco, Pedro Henrique Simm Pires de Aguiar, Gustavo Rassier Isolan, Alvaro Campero, Maria Lourdes Peris Barbo, Paulo Henrique Pires de Aguiar
Summary: This study analyzed the variations of the posterior inferior cerebellar artery (PICA) and emphasized the importance of studying and reviewing its different topographies. Striking variations were found, and the study highlighted the implications of these variations for surgical strategies in treating aneurysms.
TURKISH NEUROSURGERY
(2022)
Article
Clinical Neurology
Benedito Jamilson Araujo Pereira, Antonio Marcondes Lerario, Paula Rodrigues Sola, Talita de Sousa Laurentino, Dipika R. Mohan, Antonio Nogueira de Almeida, Paulo Henrique Pires de Aguiar, Wellingson da Silva Paiva, Alda Wakamatsu, Manoel Jacobsen Teixeira, Sueli Mieko Oba-Shinjo, Suely Kazue Nagahashi Marie
Summary: The authors identified genetic and transcriptional signatures associated with tumor progression and recurrence in meningiomas. They found that upregulated genes related to metabolism and cell cycle, and downregulated genes related to immune response and extracellular matrix remodeling in grade 2 meningiomas, particularly with recurrent tumors. EZH2 gene expression level correlated positively with cell cycle genes and negatively with immune response and regulation of cell motility genes.
JOURNAL OF NEUROSURGERY
(2022)
